Acidemia Detected on Venous Blood Gas After Out-of-Hospital Cardiac Arrest Predicts Likelihood to Survive to Hospital Discharge

Carr, Casey; Carson, Kathryn A.; Millin, Michael G.

doi:10.1016/j.jemermed.2020.06.007

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Previous studies have focused on DKA or trauma. Similarly, outcome data for patients with metabolic acidosis in the ED have been limited to specific settings, including out-of-hospital cardiac arrest (OOHCA), [9] , [10] , [11] acute decompensated heart failure, 12 , 13 poisonings, 14 sepsis, 15 , 16 traumatic brain injury, 17 and trauma. 18 Lactataemia with or without acidosis has also been investigated for any prognostic utility in ED patients.…”

Section: Discussionmentioning

confidence: 99%

Decompensated metabolic acidosis in the emergency department: Epidemiology, sodium bicarbonate therapy, and clinical outcomes

Guy

Holmes

Kishore

et al. 2023

Critical Care and Resuscitation

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Section: Discussionmentioning

confidence: 99%

Decompensated metabolic acidosis in the emergency department: Epidemiology, sodium bicarbonate therapy, and clinical outcomes

Guy

Holmes

Kishore

et al. 2023

Critical Care and Resuscitation

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“…The correctness of a BG test depends on the correct collection and analysis of blood samples, and laboratory errors account for most of medical errors [ 8 ]. However, in the case of VBG, many errors occur before analysis and when collecting blood samples that leads to incorrect concentrations of blood gases [ 9 ]. The efficiency of this diagnostic tool depends on the sampling accuracy, the syringe volume, the amount of blood sample, the type and amount of heparin, storage, and timing of sending the sample to interpret the results correctly.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Heparin Concentration on Results of Venous Blood Gas of Patients admitted to Cardiac Intensive Care Unit: A double-blind clinical Trial

Hadipourzadeh¹,

Lakziyan²,

Shabani³

et al. 2022

BioMedicine

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Background The aim of the present study was to investigate the effect of heparin (1000 IU/mL) in the blood sample on the results of venous blood gases of patients admitted to the cardiac intensive care unit. Materials and methods The present double-blind randomized clinical trial study was performed on 282 samples from 141 patients admitted to the cardiac intensive care unit. Insulin syringes with heparin (1000 IU/mL) and heparin (5000 IU/mL) and 1 cc of blood sample were taken from the peripheral vein, then distributed in two syringes and given to the analyzer. Results In the present study, the mean age of the samples was 49.96 ± 9.58. There was a statistically significant difference between the two groups in terms of values of partial pressure of carbon dioxide (PCO2) (P < 0.001), partial pressure of oxygen (PaO2) (P < 0.001), blood oxygen saturation (P < 0.001), bicarbonate ion (P < 0.001), excess base (P < 0.001), hemoglobin (P < 0.001), calcium (P < 0.001), potassium (P < 0.001), and sodium (P < 0.001) in the two groups. Conclusion Overall, heparin (1000 IU/mL) led to a less disruption in the results of venous blood gases, and since it has not significantly increased the risk of clots, it is recommended to be used for venous blood gas sampling.

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“…Blood pH is affected by both respiratory and metabolic disorders. Although Weil et al found that arterial blood pH values do not reflect the pH value in the tissue properly during CPR ( 10 ), a recently published study by Carr et al found that pH values predicted survival to hospital discharge ( 11 ). BD is influenced by all unmeasured anions (lactate, uraemia, ketone bodies etc.)…”

Section: Introductionmentioning

confidence: 99%

Initial Blood pH, Lactate and Base Deficit Add No Value to Peri-Arrest Factors in Prognostication of Neurological Outcome After Out-of-Hospital Cardiac Arrest

et al. 2021

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Background: In cardiac arrest survivors, metabolic parameters [pH value, lactate concentration, and base deficit (BD)] are routinely added to peri-arrest factors (including age, sex, bystander cardiopulmonary resuscitation, shockable first rhythm, resuscitation duration, adrenaline dose) to enhance early outcome prediction. However, the additional value of this strategy remains unclear.Methods: We used our resuscitation database to screen all patients ≥18 years who had suffered in- or out-of-hospital cardiac arrest (IHCA, OHCA) between January 1st, 2005 and May 1st, 2019. Patients with incomplete data, without return of spontaneous circulation or treatment with sodium bicarbonate were excluded. To analyse the added value of metabolic parameters to prognosticate neurological function, we built three models using logistic regression. These models included: (1) Peri-arrest factors only, (2) peri-arrest factors plus metabolic parameters and (3) metabolic parameters only. Receiver operating characteristics curves regarding 30-day good neurological function (Cerebral Performance Category 1-2) were analysed.Results: A total of 2,317 patients (OHCA: n = 1842) were included. In patients with OHCA, model 1 and 2 had comparable predictive value. Model 3 was inferior compared to model 1. In IHCA patients, model 2 performed best, whereas both metabolic (model 3) and peri-arrest factors (model 1) demonstrated similar power. PH, lactate and BD had interchangeable areas under the curve in both IHCA and OHCA.Conclusion: Although metabolic parameters may play a role in IHCA, no additional value in the prediction of good neurological outcome could be found in patients with OHCA. This highlights the importance of accurate anamnesis especially in patients with OHCA.

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Acidemia Detected on Venous Blood Gas After Out-of-Hospital Cardiac Arrest Predicts Likelihood to Survive to Hospital Discharge

Cited by 6 publications

References 24 publications

Decompensated metabolic acidosis in the emergency department: Epidemiology, sodium bicarbonate therapy, and clinical outcomes

Decompensated metabolic acidosis in the emergency department: Epidemiology, sodium bicarbonate therapy, and clinical outcomes

The Effect of Heparin Concentration on Results of Venous Blood Gas of Patients admitted to Cardiac Intensive Care Unit: A double-blind clinical Trial

Initial Blood pH, Lactate and Base Deficit Add No Value to Peri-Arrest Factors in Prognostication of Neurological Outcome After Out-of-Hospital Cardiac Arrest

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